FALLS CHURCH, Va. –
Welcoming a new child into the family is a joyous event. But there’s also much to do, and much to learn, especially for first-time parents. How will you handle your new child’s health care coverage? As a TRICARE beneficiary, what’s the best way to extend your coverage to your baby?
“Finding the right health care coverage for your newborn is a critical first step,” said Shane Pham, program analyst with TRICARE Health Plan’s Policy and Programs Section at the Defense Health Agency. “Your newborn will be taking many trips to the doctor in that first year. You want to make sure that those doctor trips, as well as prescriptions and other health care concerns, are covered by the right plan.”
You likely have many questions about how to set up TRICARE coverage for your child. Here are answers to some frequently-asked questions from new parents.
Q: What is the first step?
A: The first step to getting TRICARE coverage is to register your child in the
Defense Enrollment Eligibility Reporting System (DEERS). This also applies if you
adopt or have a child placed in your home by
court appointment. DEERS registration ensures that your child can use TRICARE. Keep in mind, there’s only a 90-day window from your child’s birth or placement to register in DEERS for stateside beneficiaries (120 days for overseas beneficiaries).
How do you register your child in DEERS? You’ll need to visit a
Uniformed Services ID card office. Remember to bring your child’s birth certificate, proof of adoption, or letter of placement. You don’t need to wait for your child to receive a Social Security number, just remember to update your child’s
DEERS record once he or she receives a Social Security number.
Q: What is the second step I need to take?
A: After you register your child in DEERS, you need to
enroll them in a TRICARE health plan. Enrollment in a TRICARE health plan is needed to be covered by TRICARE.
For some, enrollment might be automatic, depending on your status and where you live. In most cases, for stateside active duty families:
- Your child is automatically enrolled in TRICARE Prime if living in a Prime Service Area (PSA).
- If living outside of a PSA, your child is automatically enrolled in TRICARE Select.
You have 90 days to change your child’s enrollment to a different
TRICARE health plan.
As stated in the
TRICARE Maternity Care Brochure, the date of your child’s birth, adoption, or placement by the court is a
Qualifying Life Event (QLE). This opens a window for you to add or make changes to your own TRICARE coverage. Stateside sponsors have 90 days from the QLE to register their child in DEERS.
Q: What if I don’t register my child in DEERS in time?
A: If you miss the window to register your child in DEERS, you’ll have to wait for another QLE or for the annual
TRICARE Open Season. Once an active duty family enrolls their child, TRICARE coverage is backdated to the child’s date of birth or placement. If you’re late registering your child in DEERS, your child will only be able to get care at a
military hospital or clinic during that time, if space is available. You’ll be responsible for the full cost of medical treatment during this time.
Q: What if we’re living overseas?
A: Overseas sponsors have 120 days to register their child in DEERS. After you register, your child is automatically enrolled in
TRICARE Select Overseas. Be sure your address in DEERS shows as overseas for automatic enrollment to work. You have 90 days to change or transfer your child’s enrollment to
TRICARE Prime Overseas or
TRICARE Prime Remote Overseas, as long as the child is eligible and command-sponsored. If you change enrollment, your child’s coverage will still be backdated to the date of birth or placement.
Q: Are the rules different for retirees?
A: Yes. There is no automatic enrollment for your child if you’re a retiree. Also, there is no backdating your child’s TRICARE coverage if you miss the deadline to register in DEERS. Keep that in mind, and don’t forget to register your child in DEERS before the deadline. You’re also responsible for all costs from day 91 (or 121 if overseas) until you enroll your child in a TRICARE health plan.
Once you enroll your child, make sure you learn about all the benefits of your TRICARE plan. TRICARE covers
well-child care from birth through age 5. This includes routine services, like
newborn care,
vaccinations, and more.
For more information on how you get coverage for your newborn child, check out the
TRICARE Maternity Care Brochure and
Giving Birth or Adopting page. If you have any questions or concerns, be sure to contact your
TRICARE regional contractor.